What Causes Irritable Bowel Syndrome (IBS)?
By Carolyn Dean, M.D., N.D.

Many theories exist about the cause of IBS. However, only one cause of IBS is currently accepted by conventional medicine. According to doctors and researchers, IBS can occur after a bowel infection, either involving bacteria or parasites. However, not all people with IBS have had a previous bowel infection, so what causes their IBS?

Medical researchers are considering several possible causes of IBS. However, they appear to set the stage for IBS making people more susceptible to the condition. These include:
  1. Use of analgesics: In survey studies, researchers have found that the ingredient in Tylenol, acetaminophen, has been frequently used by people who develop IBS-diarrhea. This drug is known to cause elevated levels of serotonin, and research indicates that serotonin may become elevated in patients with IBS-diarrhea after eating.
  2. Brain-bowel chemical imbalance: The brain and the gut are intimately connected by both the nervous system and by neurotransmitter chemicals, such as serotonin and norepinephrine. Both chemicals may be involved with the production of IBS symptoms. So far, we know that diarrhea can occur when high amounts of serotonin inhibit norepinephrine and cause levels of acetylcholine to increase. On the other hand, when norepinephrine levels increase, the result is constipation, as well as a lowering of serotonin levels and blockage of acetylcholine. For IBS patients, this chemical dance may lead to the fluctuating bowel symptoms of constipation and diarrhea. But we must ask what the cause of the imbalance is in the first place.
  3. Female hormones: Considering that men don’t have high amounts of female hormone, and men do suffer from IBS, female hormones are not the cause of IBS. However, women have twice the incidence of IBS as men.

Mistaken Identity

Your intolerance for certain foods can slip by unnoticed for decades, and then one day you hear an item on TV, read an article in a magazine, go online, or read this book, and wham! You just know that wheat or dairy is no longer your friend. You know that eating bread and bagels and pizza and toasted cheese sandwiches are doing you in. Identifying a food allergy, sensitivity, or food intolerance can be exciting, because if you stop eating certain foods you have a chance of getting your IBS-like symptoms off your back. Gluten enteropathy and lactose intolerance produce symptoms that can be identical to IBS.

Gluten enteropathy (celiac disease) Gluten is a protein that is mainly found in four grains: wheat, rye, oats, and barley. (Yes, that’s toast, rye crackers, oatmeal, and barley soup!) Enteropathy is quite simply defined as a disease of the gastrointestinal tract. In this case, the disease is caused by gluten. Some people are extremely allergic to gluten, and some of the symptoms are identical to IBS.

This disease is also called celiac disease and carries another name -tropical sprue (don’t ask why!). It’s a genetic disease, but most people don’t know they have it. Many families who share the condition just think all that farting and running to the bathroom is normal.

The classic symptoms for celiac disease include diarrhea, short stature, anemia, and weight loss. Doctors are now finding that liver problems, thyroid problems, gas and bloating, skin lesions, and chronic fatigue may also be related to celiac disease.

Gluten enteropathy occurs because the immune system gets the idea that gluten is bad and attacks it using IgA and IgG antibodies. The lining of the small intestine suffers major collateral damage during the assault resulting in malabsorption and malnutrition.

This disease is more common than people think. Researchers consider it one of the most common lifelong genetic diseases in the West. It is widespread in Scotland and Ireland, with an incidence of 1 in 122 people of Scottish and Irish descent. It occurs in 1 in 200 people in Sweden, but only in 1 in 10,000 in Denmark. There is some speculation that celiac disease is so common in Scotland and Ireland because of the heavy grain diet in those countries.

Surprise, surprise! The way to treat gluten enteropathy and gluten allergy is to stop eating gluten. Period. If you suffer from gluten enteropathy or suspect you might, there are a host of nongluten grains that may fill in that gap in your diet (rice, quinoa, amaranth, buckwheat, kamut, and millet). Because grains supply vitamins and minerals necessary to the body, diet is important, as are dietary supplements.

Lactose intolerance

Lactose (milk sugar) intolerance occurs when your body doesn’t produce enough lactase enzymes to digest dairy products. You may be one of the more than 50 million Americans who are lactose intolerant or lactose sensitive –yes, 50 million. The symptoms of lactose intolerance are just like the symptoms for IBS:
  • Abdominal pain and bloating
  • Constipation
  • Diarrhea (usually very runny)
  • Alternating constipation and diarrhea
  • Cramps
  • Gas
  • Vomiting
Here’s what happens when you don’t digest milk and cheese: Dairy that is not broken down properly by enzyme action travels through your intestines, attracting a considerable amount of fluid in order to dilute it. This mass of fluid alone is enough to cause an episode of watery diarrhea. If that isn’t bad enough, the unabsorbed lactose (which is, after all, a sugar) becomes food for the trillions of bacteria and yeast in your intestines. Through a process of digestion and fermentation, these sugar-loving organisms create what amounts to a gas-producing factory in your gut.

A certain group of people with lactose intolerance develops chronic constipation. We’ve heard horrible stories of people going from doctor to doctor for decades because they can only have a bowel movement every two or three weeks. When it finally comes out it is hard as a rock and can cause bleeding and tearing of the rectum. They’re told to eat more fiber, drink more water, and exercise, but doing so makes no dent in this type of constipation. The cure is to stop consuming dairy products.

Yogurt and kefir (a fermented milk product popular in Europe) seem to be much less of a problem for people who are lactose intolerant because the fermentation process digests much of the lactose in these products. Plain organic yogurt and kefir are the best kinds to eat. They contain good bacteria called probiotics and don’t have the high amounts of sugar that are in the sweetened varieties.

Antibiotics, an Iatrogenic Cause of IBS Over the past several decades, the U.S. population has grown dependent on antibiotics to treat even minor infections. Their overuse has resulted in the creation of antibiotic-resistant bacteria that have learned to outfox the most brilliant pharmaceutical scientists.

Antibiotics kill small, one-celled organisms; that’s their job. When we take them to stop a bad bacterial infection, however, they aren’t smart enough to tell the difference between the good guys and the bad guys. Thus, even the good bacteria get wiped out. The fact that the good bacterial count diminishes with antibiotic treatment isn’t the end of the story. In the vacuum left after antibiotics wipe out the bacterial population of the gut, a normal gut fungus or yeast called Candida albicans takes up residence.

Certain antihistamines, antibiotics, antacids containing magnesium, laxatives, diuretics, sedatives, caffeine-containing medications, antidepressants, and mineral supplements containing excessive amounts of magnesium can trigger IBS symptoms.

The Benefits of Magnesium

After it’s absorbed into the bloodstream and carried to cells, magnesium is an important mineral for preventing heart disease and muscle spasms and for relaxing the muscles and blood vessels. It also has a relaxing effect on the bowel. However, too much magnesium inside the gut irritates the gut lining. So if it is not absorbed, it has laxative effects. All magnesium salts can stimulate the intestines, especially magnesium oxide, and are useful if you are constipated. But people with IBS-diarrhea do well on angstrom-size magnesium which is almost completely absorbed by the cells. instead of causing diarrhea. Magnesium oil has even less side effects because it can be sprayed on the skin and never touches the GI tract –but it can relax gut tension.

IBS and Yeast

When antibiotics kill off the natural Lactobacillus bacteria in your intestines, when cortisone creams, inhalers, or pills stimulate yeast growth, when you take the birth control pill, when you are under massive stress, or when you eat a high sugar diet, yeast grows wild. It grows out of its boundaries in the large intestine and takes up residence in the small intestine where it can poke holes in the lining of your small intestine, which can lead to a health problem commonly called leaky gut syndrome.

When it grows out of control in the intestines, yeast causes gas and bloating because it produces toxic gases. It can spread to the vagina and cause local burning, itching, and discharge. Moving up to the esophagus and mouth, it causes an oral yeast infection called thrush. (Thrush is commonly seen in newborn babies who catch a case of Candida from their mothers -either by traveling through the birth canal that is loaded with yeast or just by picking it up from their mothers’ skin when breastfeeding.)

Yeast also produces widespread effects all over the body because of the 180 different toxins that are byproducts of its metabolic functions. Just think of all the urine, feces, sweat, expelled air, and expelled gases that humans produce. Yeast has its own excretions as well, and some of them are mighty nasty. Yeast even produces alcohol that can make you feel and act drunk even though you haven’t touched a drop. And those toxins are absorbed through the leaky gut that yeast creates in the intestines and can cause symptoms from head to toe, including all the symptoms of IBS.

So what can you do to avoid all these nasty effects? The solutions are pretty simple:
  1. Avoid unnecessary antibiotics.
  2. Reduce the amount of sugar, wheat, and dairy you consume.
  3. Take a probiotic supplement or eat organic, sugar-free yogurt every day.
  4. Go to www.yeastconnection.com for an effective yeast-fighting program that’s easy to follow.
IBS is also associated with a number of hard-to-treat conditions but by avoiding sugar, wheat, dairy and treating yeast, many people with these conditions improve dramatically.
  1. PMS
  2. Fibromyalgia
  3. Insomnia
  4. Painful periods
  5. Urinary frequency
  6. Chronic pelvic pain
No matter what causes you to feel symptoms of IBS, there is abundant hope for you to feel better by opening yourself up to the possibility of diet and lifestyle change.

Dr. Carolyn Dean, M.D., N.D.

Proficient in both conventional and alternative medicine Dr. Dean offers private consultations by phone. If you require individualization of the advice offered in this article, you can contact Dr. Dean at www.carolyndean.com or by email at drdean@carolyndean.com. At www.carolyndean.com, under Dean Wellness, you can find a list of food and supplement resources including food-based organic vitamins and angstrom-size minerals that Dr. Dean recommends.

Dr. Dean graduated from medical school in 1978 and holds a medical license in California. She is also a graduate of the Ontario Naturopathic College, now the Canadian College of Naturopathic Medicine, where she sat on the Board of Governors for six years.

Dr. Dean is an expert in difficult to diagnose conditions such as digestive and intestinal disorders (IBS); hormone imbalance and estrogen dominance; and yeast overgrowth as evidenced by three of her books, IBS for DUMMIES, Hormone Balance, and The Yeast Connection and Women’s Health. Another of Dr. Dean’s areas of expertise is magnesium. In her latest book, The Magnesium Miracle she uncovers evidence of magnesium deficiency in 22 health conditions including heart disease, arthritis, PMS, chronic fatigue syndrome, fibromyalgia, and anxiety. Dr. Dean is able to advise what types of magnesium are best suited for these conditions.

Dr. Dean has authored a total of twelve books to share her extensive knowledge in both traditional and alternative medicine. These titles include Natural Prescriptions for Common Ailments, Menopause Naturally, Homeopathic Remedies for Children's Common Ailments, The Miracle of Magnesium, Everything Alzheimer's, Hormone Balance, The Yeast Connection and Women’s Health, IBS for Dummies, Death by Modern Medicine, The Complete Natural Medicine Guide to Women’s Health, Solve it With Supplements, and The Magnesium Miracle.


This article is an edited excerpt from IBS for Dummies (Wiley 2005)




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